CHICAGO  Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die. Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals so that everybody will be thinking in the same way when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won’t get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

People older than 85.

Those with severe trauma, which could include critical injuries from car crashes and shootings.

Severely burned patients older than 60.

Those with severe mental impairment, which could include advanced Alzheimer’s disease.

Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Triaging patients in this sort of situation is to ensure that those likeliest to survive get treated. The problem with burn patients is that their treatment makes heavy use of medical resources, and they are unlikely to survive in any case if severely burned.

Triage techniques of this sort are used by the military and in any disaster situation. It isn’t pretty, but plans need to be made.

Whatever happened to saving lives—as many as possible? This reminds me of the “Values Clarification” stuff that has been in schol; i.e. if you have to throw someone over from a lifeboat, who would you toss and why?

15
posted on 04/26/2009 12:31:20 AM PDT
by bushwon
(Wonder if our founding fathers would even recognize the USA?!)

noun
1. the process of sorting victims, as of a battle or disaster, to determine medical priority in order to increase the number of survivors.
2. the determination of priorities for action in an emergency.
adjective
3. of, pertaining to, or performing the task of triage: a triage officer.
verb (used with object)
4. to act on or in by triage: to triage a crisis.
Origin:
192530; < F: sorting, equiv. to tri(er) to sort (see try ) + -age -age

Still, though, I dont like the thought of playing god with peoples lives.

That is why they make the list.

In a situation such as a pandemic the need for medical care increases maybe in a geometric progression but the medical care resources can not. Some medical professionals will succumb to the disease and so the available medical care will actually decrease.

The list described will provide guidance to medical decision makers in a very difficult position. Someone will have to decide who will receive life saving care when there is not enough to go around.

This list will do more than decide who gets medical care it will also provide legal cover for those in the unenviable position of making those decisions. We all know that after the crisis is over the trial lawyers will be chumming the waters for clients disgruntled that some relative did not receive care.

This list will hopefully provide necessary cover for these people who will have to make decisions under very stressful conditions.

Just about a century ago, the captain of the Titanic had to make difficult decisions too. Amazingly, the weak and the most vulnerable weren’t left on board to perish. Was the captain wrong? Would he make the same decision today? Just wondering. Afterall, we still call him a hero.

First standard medicine needs to come up with an effective flu treatment, and then they can have the hubris to have this discussion. Right now, once you get sick with the flu it’s up to God, not your doctor, whether you survive.

Triage is NOT supposed to be used to selectively cull the population! It's supposed to be used to help the most people survive, regardless of *who* those people are.

In a triage situation where one has to choose between a normal adult with a 10% chance and a disabled person with a 70% chance of surviving that particular crisis you choose the disabled person. You don't assign a value to each person, as a *person*, then decide if you're going to treat them or not.

That is *eugenics*, not triage!

32
posted on 04/26/2009 1:53:07 AM PDT
by Marie
("When the people find they can vote themselves money, that will herald the end of the republic.")

Honestly, I think that this is the socialist government's reaction to their own broken system. They cripple *everything* about our economy then decide to make the "hard decisions" (killing everyone but THEM) so that we can afford their evil version of "utopia".

34
posted on 04/26/2009 1:57:18 AM PDT
by Marie
("When the people find they can vote themselves money, that will herald the end of the republic.")

Try acting rationally. As it happens I am older (66), disabled, diabetic, and am in 3rd stage Congestive Heart Failure and A-Fib. In the circumstances being considered I would be less likely to be treated than any of your folks. I definitely want to go on living, but if I found that a Doctor had to let a healthy young person die and treated me because of some policy of fairness, I would feel ashamed.

Just about a century ago, the captain of the Titanic had to make difficult decisions too. Amazingly, the weak and the most vulnerable werent left on board to perish.

Those who had the most to contribute to society's future were saved-- i.e. children, their mothers, and other women who might bear children in the future. Weak, vulnerable, elderly men were left to go down with the ship.

It's also not directly comparable because what happened to the Titanic did not affect societal integrity as a whole. However, if doctors across the country chose to let healthy young men and women die in a pandemic so they could save the nursing home patients, retarded children, elderly multi-drug dependent cardiac cripples, and lunatics, who would rebuild civilization and look after all the others?

It sounds cruel and callous to let such helpless people die, but it is morally right and necessary in the case of a dire emergency.

Whatever happened to saving livesas many as possible? Duh. That's exactly what this report clarifies - how to direct resources to maximize saving lives. It lists those types of patients most likely to die in any case and most likely to need disproportionate amounts of scarce medical resources during a mass medical emergency.

OK. Come on over to my house. Meet my son. He's 15 years old. Got an IQ of 145. He loves animals, has a great sense of humor and wants to be a volunteer firefighter. He can shoot, build traps from scratch and is currently nursing a tomato plant. He loves G-d, passionately argues politics with his grandfather and is very much looking forward to being a husband and father. He's used his humor to overcome more hell than most people will ever know. His motto is, "Where there's breath, there's hope." He's counseled a grown woman out of suicide with that humor and compassion.

You tell him that he's "life not fit for life" because G-d saw fit to "tweak" his immune system.

If people *choose* to give their lives to save another, that's fine. But it's IMMORAL to allow someone to die just because they're weak or disabled.

Sorry that I can't be "rational" about my only son being put on a eugenics culling list.

(My daughter might make it. Her problem is correctable with surgery. How *grateful* I should be that "they" might give her a chance to continue breathing. /s)

And YES, I believed that life is precious and worth fighting for *before* my son was diagnosed. "Compassionate" Conservatives, my ass!

40
posted on 04/26/2009 2:09:54 AM PDT
by Marie
("When the people find they can vote themselves money, that will herald the end of the republic.")

I am sorry that you have this position, since modified versions of this triage process are used every day in every ER in the world. In these non-emergency times those in the greatest and most immediate need of medical attention go to the head of the line. In the case of an emergency involving a great shortage of medical resources, the triage procedure always has and always will operate the way discussed in this article. Those who do not like it are free to start their own hospital.

However, if doctors across the country chose to let healthy young men and women die in a pandemic so they could save the nursing home patients, retarded children, elderly multi-drug dependent cardiac cripples, and lunatics, who would rebuild civilization and look after all the others?

If we can coldly allow the people who raised us and who taught us G-d and morals, the innocents with Down's Syndrome, children who have diabetes, and all the other vulnerable people among us to die without even *trying* to save them, then we're not worth rebuilding.

This "Logical" and "Rational" way of thinking gave us Nazi Germany, Planned Parenthood and Professor Singer. "Life not Worthy of Life" they called it. These same people can just as easily decide that people of a certain political persuasion have a mental illness (where have we heard that recently?) and also need to be culled.

Hitler began his killing spree with disabled *children* for the love of G-d! Whether it's by the ovens or by simple neglect, the crime against humanity is the same.

The difference between a conservative and a liberal is that we VALUE life - ALL LIFE. We kill the murderer because he *took* a life and that is the only crime that has the punishment. We champion the unborn, the baby with Down's Syndrome, the coma patient. We fight the killing of our elderly. We take great care when it comes to "pulling the plug" or donating organs because we hold human life as sacred and precious.

When we become disheartened and even consider a situation where we can't champion *all* life, we become G-dless liberals and we've lost ALL faith.

42
posted on 04/26/2009 2:26:35 AM PDT
by Marie
("When the people find they can vote themselves money, that will herald the end of the republic.")

So you’re a doctor, and you have 3 doses of Tamiflu left in your medicine cabinet, and the following 4 patients:

- A comatose 87-year-old with multi-organ failure, who in all likelihood will die within the next week no matter what you do
-A previously healthy 23-year-old mother of 3 small children
-A previously healthy 35-year-old fireman and father of two
-A previously healthy 9-year-old boy.

Who gets the Tamiflu? If you choose the obvious answer, congratulations, you just performed an act of triage, you Godless liberal.

If you’d give the medicine to the 87-year-old, I’d like for you to explain your reasoning, and I’d like for you not to be in charge of anything more complicated than a hot dog cart during a real pandemic.

So, according to you, Sarah Palin's Down's Syndrome baby is "Life not worthy of life".

Guess she should've aborted him after all. Saved everyone the trouble.

We are no longer human in America.

Nine months of pregnancy - six of those months on bedrest. Quit college. Quit my job. Fifteen years of dedication. Teaching, loving, arguing with doctors... Five years of sleepless nights monitoring blood sugar. Watching him grow into a moral and beautiful young man. Watching a soul develop.

All for nothing.

Why don't you just come on over and put a bullet in his head if he's worth so little to you? But I'm sure he's not the only one... could get messy. I know! We'll build OVENS to dispose of the bodies! Much cleaner...

Sure, he's already saved one healthy, productive life, but how much more good could he *really* do? How much could he actually contribute to the State? After all, his immune system isn't quite perfect. He does have trouble keeping his blood sugars "just so". He still has to finish high school and go to college before he really has a Value as a Citizen. And he does burn up about $400 a month in medical expenses... and that Universal Health Care is a bit pricey. Perhaps we should look at the bottom line a little closer -

- instead of looking at the gift he offers humanity by just being HIM.

That is NOT what they're saying! They're not saying, "if you're down to X you do Y". They're saying, "In case of disease, don't worry about anyone with a disability, diabetes or the elderly."

Don't you see? They're taking it to a whole new level. If there's a pandemic, automatically stop treating X.

This is NOT OK. Why can't you people see that we're not dealing with rational, humane people? They're saying, if there is and emergency AND if you have a "normal adult" with a 20% chance of survival and a child with Down's Syndrome with a 75% if survival, you are to treat the "normal" person. Both may die, but they don't care.

They don't want the Down's Syndrome child to live.

In normal triage situations, the Down's child would get the treatment, because he wouldn't be devalued as a human being. Triage just looks at the odds of surviving a certain situation, not the person surviving it. Triage doesn't give a crap is the person who survives is good for the gene pool, or the state. It only cares who will survive the crisis in question.

This mandate changes all that. Now doctors are supposed to look at the value of the human being.

In big and small ways, rationing is a form of triage and with the new health care, there will be a govt bureau encharged with deciding what treatments are given, which are not. A form of everyday triage.

I do think “ethicists” are people who love to talk about who gets “culled” and appointed themselves to do so.

Hey. This is the Son of Marie. My mom wanted me to read this thread and y'all need to start thinking like Captain Kirk in the Kobayashi Maru scenario. If you can't win you need to cheat. Don't accept defeat! :-) Where there's breath, there's hope.

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